Will private medical insurance be "stayed" or "abandoned" under the epidemic?
Under the influence of the epidemic, the medical and health departments of various states have adjusted the arrangements for public medical treatment. In addition to continuing to arrange the first type of emergency surgery, elective surgery (also known as "non-urgent surgery") has basically been stopped or postponed, and private medical care has been purchased. Insured people are therefore affected.
Usually, people buy private insurance to avoid too long waiting time for medical treatment or to get services that are not covered by public medical care. So should we continue to pay premiums during the epidemic, and how can we get better medical services?
Choice, an Australian consumer rights organization, analyzed the medical services that people can enjoy during the epidemic and made some suggestions for private medical insurance. This article summarizes related policies and private medical insurance recommendations for readers' reference.
According to data estimated by the federal government, during the six months when the government restricted non-urgent surgical operations, medical insurance companies saved between A$35 billion and A$55 billion in premiums. Private Healthcare Australia, a private health insurance agency, said that it will have to wait for the Australian Prudential Regulation Authority (APRA) to report the next quarter, that is, the actual data in April and May, to reflect the specific reduction in the premium paid to the hospital, and After the government relaxes restrictions on non-urgent surgical operations, it will increase the expenditures of insurance companies.
Why do I need private health insurance?
＊Tax reasons. Income exceeding the tax threshold will be required to pay the National Health Insurance Tax (Medicare Levy) to the tax bureau, and different incomes need to pay different proportions of the National Health Insurance tax. If you have purchased the corresponding level of private medical insurance, you can get a national health insurance tax reduction.
＊It is expected that surgery will be required in the hospital within two years. Although the state governments have invested more funds, it is intended that the backlog of elective surgery patients can be operated as soon as possible. But if you have private medical insurance, the surgery schedule may be faster.
＊If you arrive at the age and situation where you need to use the hospital.
Under what circumstances should the policy be lowered, some items should be cancelled, or insurance should be suspended?
Under the current circumstances, some additional services (such as dentistry, chiropractic, psychotherapy, and physical therapy) cannot be provided due to the influence of social distancing policies, so there is no need to keep these medical insurance items.
Some items in private medical insurance, such as pregnancy medical insurance, bariatric surgery, dialysis, hip/knee replacement surgery, and cataract surgery, cannot be performed in the short term due to the impact of the epidemic. These items are often items in high-value insurance policies, so you can consider making the insurance monotonic low.
If you do not want to cancel private medical insurance, but you will not be able to use these items in the next few weeks or months, you can apply to the insurance company to suspend these items.
Please note that during the suspension of private health insurance, you will not be able to use private health insurance, and if you apply for reinstatement, the private health insurance company’s policies will have different flexibility. In addition, the suspension of private medical insurance for high-income groups also means more taxes will be paid.
What other ways can save premiums?
The vast majority of private health insurance companies suspended premium increases before October 10. In addition, there are the following ways to save money.
＊Apply for premium exemption during financial difficulties: Many medical insurance funds have set up difficult funds for members. Therefore, if a member becomes unemployed, he can apply for a premium exemption for a certain period of time. Medical insurance companies generally reply that it can be suspended, but private health insurance cannot be used during the suspension, so you should try to get exemptions so that you can still enjoy private health insurance.
＊Require premium discounts: From a legal point of view, your private health insurance company can legally give you a premium discount of up to 12%, which is equivalent to 6 weeks of less premium payment each year. Health Partners has reduced premiums for all members. If you purchase other private medical insurance, please call the insurance company to apply for a discount.
Can private medical insurance allow patients to receive better care?
The Australian Ministry of Health stated that if hospitalization is required due to illness, the patient does not need private medical insurance and can still get good treatment.
A spokesperson for the Ministry of Health said: "With regard to hospital treatment, it is up to doctors and hospitals to decide who receives treatment, how they should be treated, when to receive treatment, etc. (These) are not determined by the government or medical insurance companies." A spokesperson also said: “For patients infected with the new crown virus, whether there is private medical insurance has no effect on the treatment they receive.”
In Australia, general practitioners and the public health system deal with people infected during the epidemic. This means that if an Australian is unfortunately infected, the cost of treatment does not need to be personally borne.
Currently, infected patients are treated in isolation in hospitals, that is, they may be isolated in a separate room, or even the entire ward may be isolated for treatment of these patients. Therefore, whether such patients are paid by national health care or private health insurance, the treatment methods are the same.
Do private hospitals accept and treat infected patients?
The Minister of Health (Greg Hunter) has integrated private hospitals into the public hospital system. When necessary, infected patients can also be treated by private hospitals, and patients do not need to pay for hospital treatment and accommodation.
Do you need to pay for virus testing?
Public hospitals, respiratory clinics, and general practitioners can conduct free tests for people who need to be tested for the virus.
What if I don’t have a National Health Insurance Card?
In Australia, people who do not meet the requirements for applying for a National Health Insurance Card (Medicare) need to have private medical insurance or travel medical insurance. If the infected patient does not have proper medical insurance, some Australian states or territories (such as NSW, Victoria and Western Australia) will waive all related expenses for the patient's treatment in public hospitals.
There is another situation. Belgium, Finland, Italy, Malta, the Netherlands, New Zealand, Norway, Ireland, Slovenia, Sweden, and the United Kingdom have all signed reciprocal medical agreements with Australia. Passport holders from these countries can get basic medical treatment for free in Australia.
This is a new type of service aimed at reducing the contact of people in the community and reducing the risk of epidemic spread. The patient consults with general practitioners or professionals in other departments by phone or video at home. By doing so, patients do not need to wait in crowded waiting rooms, and there is no risk of contact with patients infected with the virus. Moreover, masks, gloves and protective clothing can be saved for use by frontline medical staff.
If necessary, the doctor will arrange the patient for face-to-face diagnosis and treatment. If the patient needs a medical certificate, it can also be delivered to the patient by fax, email or post.
The government encourages the public to use telemedicine services and has increased the implementation of bulk-billing (national health insurance unified reimbursement) incentive measures. Therefore, most of the following telemedicine services are free:
＊Diagnosis and treatment of chronic diseases
＊Medical services for Aboriginals and Torres Strait Islanders
＊Medical services for people with eating disorders
＊Medical services for pregnant women
＊Medical services for patients in nursing homes
＊Medical services for children with autism
＊Medical consultation outside normal working hours
For discount card holders, children under the age of 16, and infected patients, doctors will use a unified billing system (bulk bill). These people specifically include: people who are required to self-isolate or are suspected of being infected with the virus, people 70 years of age or older, Aboriginal people and Torres Strait Islander people over 50 years of age, parents of pregnant women or children under one year old, patients with chronic diseases, People with weakened immune function.
The government’s incentives will expire on September 9 and will be reassessed at that time.
Other patients may have to bear some expenses on their own. So please understand the cost in advance.
Editor in charge: Zong Minqing